Patient Billing & Financial Svcs Specialist
Job Description
Job Description
Claris Vision, LLC, is seeking a Patient Billing and Financial Services Specialist to join our company. The Patient Billing & Financial Services Specialist serves as the primary point of contact for patients regarding questions about account balances, insurance billing, statements, payment options, and financial responsibilities. This position helps patients understand their bills, resolves account inquiries, coordinates with insurance and billing teams, and promotes a positive patient experience while supporting organizational revenue cycle goals.
The position is located onsite in Dartmouth, MA, or Warwick, RI.
Essential Duties and Responsibilities
- Answer inbound patient calls regarding account balances, insurance claims, payments, refunds, and billing statements.
- Explain patient financial responsibility, including copayments, deductibles, coinsurance, and non-covered services.
- Research and resolve patient billing inquiries by reviewing claims, payments, adjustments, and account activity.
- Work collaboratively with insurance follow-up, coding, collections, and front-office teams to resolve patient concerns.
- Assist patients with payment arrangements and available financial assistance programs, as applicable.
- Process payments received by phone and document all patient interactions accurately in the practice management system.
- Identify billing errors or account discrepancies and escalate complex issues as appropriate.
- Educate patients regarding insurance benefits and billing processes while maintaining a professional and empathetic approach.
- Review returned mail, statement issues, and account demographics to ensure accurate patient information.
- Maintain compliance with HIPAA and all applicable privacy and billing regulations.
- Meet established quality, productivity, customer service, and collection performance standards.
- Perform other duties as assigned.
Knowledge, Skills, and Abilities
- Strong customer service and communication skills.
- Ability to explain complex billing and insurance concepts in a clear, patient-friendly manner.
- Knowledge of medical billing, insurance claims, and patient collections required.
- Ability to de-escalate challenging conversations and maintain professionalism under pressure.
- Strong attention to detail and problem-solving skills.
- Proficiency with electronic medical records, practice management systems, and Microsoft Office applications.
- Ability to maintain confidentiality and handle sensitive financial information.
Qualifications
Required
- High school diploma or equivalent.
- Minimum of one (1) year of customer service experience.
- Strong verbal and written communication skills.
- One (1) or more years of medical billing, healthcare customer service, or revenue cycle experience.
- Knowledge of Medicare, Medicaid, commercial insurance plans, and patient responsibility calculations.
- Must possess the physical, mental, and cognitive skills needed to complete essential tasks, including abilities such as learning, remembering, focusing, categorizing, and integrating information for comprehension, problem-solving, and timely decision-making and wield exceptional inter-personal communication skills with diverse populations.
Preferred
- Experience in ophthalmology, ambulatory surgery center, healthcare or physician practice settings.
Physical Requirements
- Ability to sit for extended periods.
- Frequent use of computers, telephones, and office equipment.
- Ability to communicate effectively with patients, providers, and staff.
Performance Metrics
- Patient satisfaction scores.
- Call quality and responsiveness.
- Resolution of patient inquiries within established timeframes.
- Collection of patient balances and payment plan adherence.
- Accuracy of account documentation.
- Compliance with organizational policies and procedures.
- Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
We are an Equal Opportunity Employer. This company does not and will not discriminate in employment and personnel practices on the basis of race, sex, age, handicap, religion, national origin or any other basis prohibited by applicable law. Hiring, transferring and promotion practices are performed without regard to the above listed items.
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